Shanise Madelena King

NPI #1487421939 in Hercules, California

Provider Information

NPI Number: 1487421939
Entity Type: Individual
Name: Shanise Madelena King
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 5, 2023
Last Updated: Dec 5, 2023

Practice Location

Address: 500 ALFRED NOBEL DR STE 275A
City: Hercules
State: California
ZIP Code: 94547-1840
Phone: (510) 230-5007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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